Lillian Nero
Florence,SC
Summary
Accomplished Sr. Claims Examiner with a proven track record. Enhancing customer satisfaction and reducing claim resolution times through expert claims analysis and efficient workflow implementation. Skilled in policy interpretation and verbal communication, adept at multitasking and problem-solving, significantly mitigated risks by identifying fraudulent activities.
Overview
5
5
years of professional experience
Work History
Sr. Claims Examiner
Genworth
03.2024 - Current
- Reduced claim resolution time by conducting thorough investigations and timely decisionmaking.
- Streamlined claims processing by implementing efficient workflow procedures.
- Mitigated company risk by identifying fraudulent activities and implementing preventative measures.
- Handled high-profile cases professionally, maintaining confidentiality while achieving satisfactory resolutions.
- Enhanced customer satisfaction through prompt communication and comprehensive claim explanations.
STD Claims Manager
Aflac
10.2022 - 11.2023
- Enhanced customer satisfaction with timely and accurate claims resolutions.
- Handled claims consistent with client and corporate policies, procedures, best practices and regulations.
- Interacted with Social Security Administration and other entities for timely processing and delivery of quality customer service and results.
- Documented and communicated timely claims information while supporting accurate outcomes.
- Established strong relationships with external partners such as medical providers, legal professionals, and repair services for efficient case management.
- Mentored new hires on company policies/procedures enabling them to quickly become proficient in managing claims.
STD/LTD Customer Care Advocate
Unum Insurance
07.2019 - 01.2022
- Maintained detailed records of each interaction, ensuring accurate documentation for future reference or follow-up purposes.
- Collaborated with team members to achieve shared goals in improving overall customer experience.
- Worked closely with other departments when necessary to address interrelated concerns affecting customer experience.
- Mentored new hires by sharing knowledge and providing guidance, contributing to a more competent and cohesive team overall.
- Managed multiple priorities under tight deadlines while remaining calm under pressure and delivering excellent results consistently.
Education
Human Resources - Human Resources
DeVry University
Downers Grove, ILSkills
- Claims analysis
- Coverage Evaluation
- Investigation techniques
- Policy Interpretation
- Claim Resolution
- Claims Processing
- Verbal Communication
- Microsoft Office Suite
- Disability claims process
- Time Management
- Attention to Detail
- Problem-solving abilities
- Multitasking
- Customer service and support
Timeline
Sr. Claims Examiner
Genworth
03.2024 - Current
STD Claims Manager
Aflac
10.2022 - 11.2023
STD/LTD Customer Care Advocate
Unum Insurance
07.2019 - 01.2022
Human Resources - Human Resources
DeVry University
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